Mat Salleh Fadhil, Nizam Ikram
AOA Accredited Fellow, Mulgrave Private Hospital, 48 Blanton Dr, Mulgrave, VIC 3170, Australia.
Ozorthopaedics, Centre for Adult Joint Arthroplasty, 1356 High Street, Malvern, VIC 3144, Australia.
SICOT J. 2025;11:25. doi: 10.1051/sicotj/2025021. Epub 2025 Apr 14.
This study evaluates complications associated with the bikini-incision direct anterior approach (DAA) total hip arthroplasty (THA) performed by a single surgeon on a standard operating table, with a focus on cases requiring large acetabular cups (≥56 mm). Secondary objectives include assessing clinical outcomes and implant survivorship.
A retrospective analysis was conducted on primary bikini-incision DAA THAs performed by a single surgeon between 2013 and 2024. Cases involving acetabular cups ≥56 mm were included, while emergency hip fracture cases and those requiring posterolateral approaches were excluded. Clinical data, radiographs, and Kaplan-Meier survival analysis were used to assess complications, Harris Hip Scores (HHS), and implant survivorship.
This study included 215 THA procedures performed on 210 male patients (mean age 67 years, BMI 28.6), with an average follow-up of 3.9 years. The primary indication was osteoarthritis (88.4%). The mean preoperative HHS was 41.8, which significantly improved to 92.6 postoperatively (p < 0.001). Complications included lateral femoral cutaneous nerve (LFCN) neuropraxia (2.3%), periprosthetic fractures (0.93%), and femoral stem subsidence (0.93%). The revision rate was 0.93%, with Kaplan-Meier analysis indicating a 99% survival rate for the stem and 100% survival for the acetabular cup at the final follow-up.
The bikini-incision DAA THA using a standard operating table provides excellent short- to mid-term functional outcomes and implant survivorship for patients requiring large acetabular cups (≥56 mm). The approach is associated with low complication and revision rates, supporting its safety and efficacy in this cohort.
本研究评估了由单一外科医生在标准手术台上进行的比基尼切口直接前路（DAA）全髋关节置换术（THA）相关的并发症，重点关注需要使用大尺寸髋臼杯（≥56mm）的病例。次要目标包括评估临床结果和植入物生存率。
对2013年至2024年间由单一外科医生进行的原发性比基尼切口DAA THA手术进行回顾性分析。纳入涉及髋臼杯≥56mm的病例，排除急诊髋部骨折病例和需要后外侧入路的病例。使用临床数据、X线片和Kaplan-Meier生存分析来评估并发症、Harris髋关节评分（HHS）和植入物生存率。
本研究包括对210例男性患者（平均年龄67岁，BMI 28.6）进行的215例THA手术，平均随访3.9年。主要适应症为骨关节炎（88.4%）。术前平均HHS为41.8，术后显著提高至92.6（p<0.001）。并发症包括股外侧皮神经（LFCN）神经失用（2.3%）、假体周围骨折（0.93%）和股骨柄下沉（0.93%）。翻修率为0.93%，Kaplan-Meier分析表明，在最后随访时，股骨柄的生存率为99%，髋臼杯的生存率为100%。
使用标准手术台的比基尼切口DAA THA为需要大尺寸髋臼杯（≥56mm）的患者提供了出色的短期至中期功能结果和植入物生存率。该入路的并发症和翻修率较低，支持其在该队列中的安全性和有效性。
